{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T08:35:24Z","timestamp":1793608524310,"version":"4.5.0"},"reference-count":55,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2023,1,19]],"date-time":"2023-01-19T00:00:00Z","timestamp":1674086400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,1,19]],"date-time":"2023-01-19T00:00:00Z","timestamp":1674086400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005713","name":"Technische Universit\u00e4t M\u00fcnchen","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005713","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["International Orthopaedics (SICOT)"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>\nThe diagnostic criteria of prosthetic joint infection (PJI) recommended by the most commonly used diagnostic algorithms can be obscured or distorted by other inflammatory processes or aseptic pathology. Furthermore, the most reliable diagnostic criteria are garnered during revision surgery. A robust, reliable addition to the preoperative diagnostic cascade is warranted. Calprotectin has been shown to be an excellent diagnostic marker for PJI. In this study, we aimed to evaluate a lateral flow test (LFT) in the challenging patient cohort of a national referral centre for revision arthroplasty.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Beginning in March 2019, we prospectively included patients scheduled for arthroplasty exchange of a total hip (THA) or knee arthroplasty (TKA). Synovial fluid samples were collected intra-operatively.<\/jats:p>\n                <jats:p>We used the International Consensus Meeting of 2018 (ICM) score as the gold standard. We then compared the pre-operative ICM score with the LFT result to calculate its diagnostic accuracy as a standalone pre-operative marker and in combination with the ICM score as part of an expanded diagnostic workup.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 137 patients with a mean age of 67 (\u00b1\u200913) years with 53 THA and 84 TKA were included. Ninety-nine patients (72.8%) were not infected, 34 (25.0) were infected, and four (2.9%) had an inconclusive final score and could not be classified after surgery.<\/jats:p>\n                <jats:p>The calprotectin LFT had a sensitivity (95% confidence interval) of 0.94 (0.80\u20130.99) and a specificity of 0.87 (0.79\u20130.93). The area under the receiver operating characteristic curve (AUC) for the calprotectin LFT was 0.94 (0.89\u20130.99). In nine cases with an inconclusive pre-operative ICM score, the calprotectin LFT would have led to the correct diagnosis of PJI.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The synovial fluid calprotectin LFT shows excellent diagnostic metrics both as a rule-in and a rule-out test, even in a challenging patient cohort with cases of severe osteolysis, wear disease, numerous preceding surgeries, and poor soft tissue conditions, which can impair the common diagnostic criteria. As it is available pre-operatively, this test might prove to be a very useful addition to the diagnostic algorithm.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00264-023-05691-3","type":"journal-article","created":{"date-parts":[[2023,1,19]],"date-time":"2023-01-19T10:13:30Z","timestamp":1674123210000},"page":"929-944","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["The synovial fluid calprotectin lateral flow test for the diagnosis of chronic prosthetic joint infection in failed primary and revision total hip and knee arthroplasty"],"prefix":"10.1007","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2816-6523","authenticated-orcid":false,"given":"Christian","family":"Suren","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor","family":"Lazic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Haller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Pohlig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R\u00fcdiger","family":"von Eisenhart-Rothe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Prodinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,1,19]]},"reference":[{"key":"5691_CR1","doi-asserted-by":"publisher","first-page":"760","DOI":"10.3899\/jrheum.140628","volume":"42","author":"M Abildtrup","year":"2015","unstructured":"Abildtrup M, Kingsley GH, Scott DL (2015) Calprotectin as a biomarker for rheumatoid arthritis: a systematic review. J Rheumatol 42:760\u2013770","journal-title":"J Rheumatol"},{"key":"5691_CR2","doi-asserted-by":"publisher","first-page":"3039","DOI":"10.1007\/s00167-018-4904-8","volume":"26","author":"SS Ahmad","year":"2018","unstructured":"Ahmad SS, Hirschmann MT, Becker R, Shaker A, Ateschrang A, Keel MJB, Albers CE, Buetikofer L, Maqungo S, St\u00f6ckle U, Kohl S (2018) A meta-analysis of synovial biomarkers in periprosthetic joint infection: Synovasure\u2122 is less effective than the ELISA-based alpha-defensin test. Knee Surg Sports Traumatol Arthrosc 26:3039\u20133047","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"5691_CR3","doi-asserted-by":"publisher","first-page":"2932","DOI":"10.1128\/JCM.36.10.2932-2939.1998","volume":"36","author":"BL Atkins","year":"1998","unstructured":"Atkins BL, Athanasou N, Deeks JJ, Crook DW, Simpson H, Peto TE, McLardy-Smith P, Berendt AR, The OSIRIS Collaborative Study Group (1998) Prospective evaluation of criteria for microbiological diagnosis of prosthetic-joint infection at revision arthroplasty. J Clin Microbiol 36:2932\u20132939","journal-title":"J Clin Microbiol"},{"key":"5691_CR4","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1302\/0301-620X.104B3.BJJ-2021-1320.R1","volume":"104-b","author":"T Cheok","year":"2022","unstructured":"Cheok T, Smith T, Siddiquee S, Jennings MP, Jayasekera N, Jaarsma RL (2022) Synovial fluid calprotectin performs better than synovial fluid polymerase chain reaction and interleukin-6 in the diagnosis of periprosthetic joint infection\u202f: a systematic review and meta-analysis. Bone Joint J 104-b:311\u2013320","journal-title":"Bone Joint J"},{"key":"5691_CR5","doi-asserted-by":"publisher","first-page":"115","DOI":"10.2106\/JBJS.20.00749","volume":"103","author":"C Deirmengian","year":"2021","unstructured":"Deirmengian C, Madigan J, Kallur Mallikarjuna S, Conway J, Higuera C, Patel R (2021) Validation of the alpha defensin lateral flow test for periprosthetic joint infection. JBJS 103:115\u2013122","journal-title":"JBJS"},{"key":"5691_CR6","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1016\/j.arth.2007.04.013","volume":"22","author":"CJ Della Valle","year":"2007","unstructured":"Della Valle CJ, Sporer SM, Jacobs JJ, Berger RA, Rosenberg AG, Paprosky WG (2007) Preoperative testing for sepsis before revision total knee arthroplasty. J Arthroplasty 22:90\u201393","journal-title":"J Arthroplasty"},{"key":"5691_CR7","doi-asserted-by":"publisher","first-page":"1139","DOI":"10.1002\/jcla.21994","volume":"30","author":"SR Fernandes","year":"2016","unstructured":"Fernandes SR, Santos P, Fatela N, Baldaia C, Tato Marinho R, Proen\u00e7a H, Ramalho F, Velosa J (2016) Ascitic calprotectin is a novel and accurate marker for spontaneous bacterial peritonitis. J Clin Lab Anal 30:1139\u20131145","journal-title":"J Clin Lab Anal"},{"key":"5691_CR8","doi-asserted-by":"publisher","first-page":"1637","DOI":"10.2106\/JBJS.G.00470","volume":"90","author":"E Ghanem","year":"2008","unstructured":"Ghanem E, Parvizi J, Burnett RS, Sharkey PF, Keshavarzi N, Aggarwal A, Barrack RL (2008) Cell count and differential of aspirated fluid in the diagnosis of infection at the site of total knee arthroplasty. J Bone Joint Surg Am 90:1637\u20131643","journal-title":"J Bone Joint Surg Am"},{"key":"5691_CR9","doi-asserted-by":"publisher","first-page":"644","DOI":"10.2106\/JBJS.L.00205","volume":"95","author":"H Gollwitzer","year":"2013","unstructured":"Gollwitzer H, Dombrowski Y, Prodinger PM, Peric M, Summer B, Hapfelmeier A, Saldamli B, Pankow F, von Eisenhart-Rothe R, Imhoff AB, Schauber J, Thomas P, Burgkart R, Banke IJ (2013) Antimicrobial peptides and proinflammatory cytokines in periprosthetic joint infection. J Bone Joint Surg Am 95:644\u2013651","journal-title":"J Bone Joint Surg Am"},{"key":"5691_CR10","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1007\/s12178-018-9513-0","volume":"11","author":"K Goswami","year":"2018","unstructured":"Goswami K, Parvizi J, Maxwell CP (2018) Current recommendations for the diagnosis of acute and chronic PJI for hip and knee-cell counts, alpha-defensin, leukocyte esterase, next-generation sequencing. Curr Rev Musculoskelet Med 11:428\u2013438","journal-title":"Curr Rev Musculoskelet Med"},{"key":"5691_CR11","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1302\/0301-620X.103B1.BJJ-2020-0953.R1","volume":"103-b","author":"D Grzelecki","year":"2021","unstructured":"Grzelecki D, Walczak P, Szostek M, Grajek A, Rak S, Kowalczewski J (2021) Blood and synovial fluid calprotectin as biomarkers to diagnose chronic hip and knee periprosthetic joint infections. Bone Joint J 103-b:46\u201355","journal-title":"Bone Joint J"},{"key":"5691_CR12","doi-asserted-by":"publisher","first-page":"971","DOI":"10.1007\/s00264-022-05357-6","volume":"46","author":"AT Hantouly","year":"2022","unstructured":"Hantouly AT, Salameh M, Toubasi AA, Salman LA, Alzobi O, Ahmed AF, Hameed S, Zikria B, Ahmed G (2022) Synovial fluid calprotectin in diagnosing periprosthetic joint infection: a meta-analysis. Int Orthop 46:971\u2013981","journal-title":"Int Orthop"},{"key":"5691_CR13","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1111\/dme.13431","volume":"35","author":"JR Ingram","year":"2018","unstructured":"Ingram JR, Cawley S, Coulman E, Gregory C, Thomas-Jones E, Pickles T, Cannings-John R, Francis NA, Harding K, Hood K, Piguet V (2018) Levels of wound calprotectin and other inflammatory biomarkers aid in deciding which patients with a diabetic foot ulcer need antibiotic therapy (INDUCE study). Diabet Med 35:255\u2013261","journal-title":"Diabet Med"},{"key":"5691_CR14","doi-asserted-by":"publisher","first-page":"482","DOI":"10.1302\/2058-5241.4.180092","volume":"4","author":"P Izakovicova","year":"2019","unstructured":"Izakovicova P, Borens O, Trampuz A (2019) Periprosthetic joint infection: current concepts and outlook. EFORT Open Rev 4:482\u2013494","journal-title":"EFORT Open Rev"},{"key":"5691_CR15","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1186\/s13075-020-02190-3","volume":"22","author":"M Jarlborg","year":"2020","unstructured":"Jarlborg M, Courvoisier DS, Lamacchia C, Martinez Prat L, Mahler M, Bentow C, Finckh A, Gabay C, Nissen MJ (2020) Serum calprotectin: a promising biomarker in rheumatoid arthritis and axial spondyloarthritis. Arthritis Res Ther 22:105","journal-title":"Arthritis Res Ther"},{"key":"5691_CR16","first-page":"205","volume":"19","author":"N Jonsson","year":"2017","unstructured":"Jonsson N, Nilsen T, Gille-Johnson P, Bell M, Martling CR, Larsson A, M\u00e5rtensson J (2017) Calprotectin as an early biomarker of bacterial infections in critically ill patients: an exploratory cohort assessment. Crit Care Resusc 19:205\u2013213","journal-title":"Crit Care Resusc"},{"key":"5691_CR17","doi-asserted-by":"publisher","first-page":"3531","DOI":"10.1016\/j.arth.2018.06.018","volume":"33","author":"MM Kheir","year":"2018","unstructured":"Kheir MM, Tan TL, Ackerman CT, Modi R, Foltz C, Parvizi J (2018) Culturing periprosthetic joint infection: number of samples, growth duration, and organisms. J Arthroplasty 33:3531-3536.e3531","journal-title":"J Arthroplasty"},{"key":"5691_CR18","doi-asserted-by":"publisher","first-page":"1473","DOI":"10.1007\/s00264-022-05421-1","volume":"46","author":"I Lazic","year":"2022","unstructured":"Lazic I, Prodinger P, Stephan M, Haug AT, Pohlig F, Langer S, von Eisenhart-Rothe R, Suren C (2022) Synovial calprotectin is a reliable biomarker for periprosthetic joint infections in acute-phase inflammation \u2013 a prospective cohort study. Int Orthop 46:1473\u20131479","journal-title":"Int Orthop"},{"key":"5691_CR19","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1016\/S0883-5403(03)00453-4","volume":"19","author":"R Malhotra","year":"2004","unstructured":"Malhotra R, Morgan DA (2004) Role of core biopsy in diagnosing infection before revision hip arthroplasty. J Arthroplasty 19:78\u201387","journal-title":"J Arthroplasty"},{"key":"5691_CR20","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1515\/cclm-2016-0522","volume":"55","author":"H Manceau","year":"2017","unstructured":"Manceau H, Chicha-Cattoir V, Puy H, Peoc\u2019h K (2017) Fecal calprotectin in inflammatory bowel diseases: update and perspectives. Clin Chem Lab Med 55:474\u2013483","journal-title":"Clin Chem Lab Med"},{"key":"5691_CR21","doi-asserted-by":"publisher","first-page":"703","DOI":"10.1302\/0301-620X.100B6.BJJ-2017-1563.R1","volume":"100-b","author":"BA Marson","year":"2018","unstructured":"Marson BA, Deshmukh SR, Grindlay DJC, Scammell BE (2018) Alpha-defensin and the Synovasure lateral flow device for the diagnosis of prosthetic joint infection: a systematic review and meta-analysis. Bone Joint J 100-b:703\u2013711","journal-title":"Bone Joint J"},{"key":"5691_CR22","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1302\/0301-620X.103B1.BJJ-2020-1381.R1","volume":"103-b","author":"M McNally","year":"2021","unstructured":"McNally M, Sousa R, Wouthuyzen-Bakker M, Chen AF, Soriano A, Vogely HC, Clauss M, Higuera CA, Treb\u0161e R (2021) The EBJIS definition of periprosthetic joint infection. Bone Joint J 103-b:18\u201325","journal-title":"Bone Joint J"},{"key":"5691_CR23","doi-asserted-by":"publisher","first-page":"1032","DOI":"10.1016\/j.arth.2019.01.051","volume":"34","author":"SZ Mirza","year":"2019","unstructured":"Mirza SZ, Richardson SS, Kahlenberg CA, Blevins JL, Lautenbach C, Demetres M, Martin L, Szymonifka J, Sculco PK, Figgie MP, Goodman SM (2019) Diagnosing prosthetic joint infections in patients with inflammatory arthritis: a systematic literature review. J Arthroplasty 34:1032-1036.e1032","journal-title":"J Arthroplasty"},{"key":"5691_CR24","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1136\/jcp.2005.027458","volume":"59","author":"L Morawietz","year":"2006","unstructured":"Morawietz L, Classen RA, Schroder JH, Dynybil C, Perka C, Skwara A, Neidel J, Gehrke T, Frommelt L, Hansen T, Otto M, Barden B, Aigner T, Stiehl P, Schubert T, Meyer-Scholten C, Konig A, Strobel P, Rader CP, Kirschner S, Lintner F, Ruther W, Bos I, Hendrich C, Kriegsmann J, Krenn V (2006) Proposal for a histopathological consensus classification of the periprosthetic interface membrane. J Clin Pathol 59:591\u2013597","journal-title":"J Clin Pathol"},{"key":"5691_CR25","doi-asserted-by":"publisher","first-page":"e793","DOI":"10.5435\/JAAOS-D-19-00850","volume":"28","author":"TG Myers","year":"2020","unstructured":"Myers TG, Lipof JS, Chen AF, Ricciardi BF (2020) Antibiotic stewardship for total joint arthroplasty in 2020. J Am Acad Orthop Surg 28:e793\u2013e802","journal-title":"J Am Acad Orthop Surg"},{"key":"5691_CR26","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1093\/cid\/cis966","volume":"56","author":"DR Osmon","year":"2013","unstructured":"Osmon DR, Berbari EF, Berendt AR, Lew D, Zimmerli W, Steckelberg JM, Rao N, Hanssen A, Wilson WR (2013) Executive summary: diagnosis and management of prosthetic joint infection: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis 56:1\u201310","journal-title":"Clin Infect Dis"},{"key":"5691_CR27","doi-asserted-by":"publisher","first-page":"570","DOI":"10.1007\/s004020000174","volume":"120","author":"R Pandey","year":"2000","unstructured":"Pandey R, Berendt AR, Athanasou NA, The OSIRIS Collaborative Study Group (2000) Histological and microbiological findings in non-infected and infected revision arthroplasty tissues Oxford Skeletal Infection Research and Intervention Service. Arch Orthop Trauma Surg 120:570\u2013574","journal-title":"Arch Orthop Trauma Surg"},{"key":"5691_CR28","doi-asserted-by":"publisher","first-page":"430","DOI":"10.2106\/JBJS.L.01793","volume":"96","author":"J Parvizi","year":"2014","unstructured":"Parvizi J, Erkocak OF, Della Valle CJ (2014) Culture-negative periprosthetic joint infection. J Bone Joint Surg Am 96:430\u2013436","journal-title":"J Bone Joint Surg Am"},{"key":"5691_CR29","doi-asserted-by":"publisher","first-page":"1450-B","DOI":"10.1302\/0301-620X.95B11.33135","volume":"95","author":"J Parvizi","year":"2013","unstructured":"Parvizi J, Gehrke T, Chen AF (2013) Proceedings of the International Consensus on Periprosthetic Joint Infection. Bone Joint J 95:1450-B-1452","journal-title":"Bone Joint J"},{"key":"5691_CR30","doi-asserted-by":"publisher","first-page":"1309","DOI":"10.1016\/j.arth.2018.02.078","volume":"33","author":"J Parvizi","year":"2018","unstructured":"Parvizi J, Tan TL, Goswami K, Higuera C, Della Valle C, Chen AF, Shohat N (2018) The 2018 definition of periprosthetic hip and knee infection: an evidence-based and validated criteria. J Arthroplasty 33:1309-1314.e1302","journal-title":"J Arthroplasty"},{"key":"5691_CR31","doi-asserted-by":"publisher","first-page":"2992","DOI":"10.1007\/s11999-011-2102-9","volume":"469","author":"J Parvizi","year":"2011","unstructured":"Parvizi J, Zmistowski B, Berbari EF, Bauer TW, Springer BD, Della Valle CJ, Garvin KL, Mont MA, Wongworawat MD, Zalavras CG (2011) New definition for periprosthetic joint infection: from the Workgroup of the Musculoskeletal Infection Society. Clin Orthop Relat Res 469:2992\u20132994","journal-title":"Clin Orthop Relat Res"},{"key":"5691_CR32","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1186\/s13018-021-02746-2","volume":"17","author":"X Peng","year":"2022","unstructured":"Peng X, Zhang H, Xin P, Bai G, Ge Y, Cai M, Wang R, Fan Y, Pang Z (2022) Synovial calprotectin for the diagnosis of periprosthetic joint infection: a diagnostic meta-analysis. J Orthop Surg Res 17:2","journal-title":"J Orthop Surg Res"},{"issue":"4","key":"5691_CR33","doi-asserted-by":"publisher","first-page":"21","DOI":"10.18637\/jss.v082.i04","volume":"82","author":"S Perez-Jaume","year":"2017","unstructured":"Perez-Jaume S, Skaltsa K, Pallar\u00e8s N, Carrasco JL (2017) ThresholdROC: Optimum threshold estimation tools for continuous diagnostic tests in R. J Stat Softw 82(4):21","journal-title":"J Stat Softw"},{"key":"5691_CR34","doi-asserted-by":"publisher","first-page":"1212.e1211","DOI":"10.1016\/j.cmi.2018.02.019","volume":"24","author":"A Plate","year":"2018","unstructured":"Plate A, Stadler L, Sutter R, Anagnostopoulos A, Frustaci D, Zbinden R, Fucentese SF, Zinkernagel AS, Zingg PO, Achermann Y (2018) Inflammatory disorders mimicking periprosthetic joint infections may result in false-positive \u03b1-defensin. Clin Microbiol Infect 24:1212.e1211-1212.e1216","journal-title":"Clin Microbiol Infect"},{"key":"5691_CR35","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1186\/1471-2105-12-77","volume":"12","author":"X Robin","year":"2011","unstructured":"Robin X, Turck N, Hainard A, Tiberti N, Lisacek F, Sanchez JC, M\u00fcller M (2011) pROC: an open-source package for R and S+ to analyze and compare ROC curves. BMC Bioinformatics 12:77","journal-title":"BMC Bioinformatics"},{"issue":"5","key":"5691_CR36","doi-asserted-by":"publisher","first-page":"650","DOI":"10.3390\/jcm8050650","volume":"8","author":"CL Roman\u00f2","year":"2019","unstructured":"Roman\u00f2 CL, Khawashki HA, Benzakour T, Bozhkova S, Del Sel H, Hafez M, Johari A, Lob G, Sharma HK, Tsuchiya H, Drago L (2019) The W.A.I.O.T. definition of high-grade and low-grade peri-prosthetic joint infection. J Clin Med 8(5):650","journal-title":"J Clin Med"},{"key":"5691_CR37","doi-asserted-by":"publisher","first-page":"534","DOI":"10.1016\/j.arth.2019.08.052","volume":"35","author":"P Salari","year":"2020","unstructured":"Salari P, Grassi M, Cinti B, Onori N, Gigante A (2020) Synovial fluid calprotectin for the preoperative diagnosis of chronic periprosthetic joint infection. J Arthroplasty 35:534\u2013537","journal-title":"J Arthroplasty"},{"key":"5691_CR38","doi-asserted-by":"publisher","first-page":"3561","DOI":"10.1016\/j.arth.2018.07.016","volume":"33","author":"N Shohat","year":"2018","unstructured":"Shohat N, Goswami K, Fillingham Y, Tan TL, Calkins T, Della Valle CJ, George J, Higuera C, Parvizi J (2018) Diagnosing periprosthetic joint infection in inflammatory arthritis: assumption is the enemy of true understanding. J Arthroplasty 33:3561\u20133566","journal-title":"J Arthroplasty"},{"key":"5691_CR39","doi-asserted-by":"publisher","first-page":"1645","DOI":"10.1097\/CORR.0000000000000336","volume":"476","author":"IK Sigmund","year":"2018","unstructured":"Sigmund IK, Yermak K, Perka C, Trampuz A, Renz N (2018) Is the enzyme-linked immunosorbent assay more accurate than the lateral flow alpha defensin test for diagnosing periprosthetic joint infection? Clin Orthop Relat Res 476:1645\u20131654","journal-title":"Clin Orthop Relat Res"},{"key":"5691_CR40","doi-asserted-by":"publisher","first-page":"971","DOI":"10.1007\/s00259-019-4263-9","volume":"46","author":"A Signore","year":"2019","unstructured":"Signore A, Sconfienza LM, Borens O, Glaudemans A, Cassar-Pullicino V, Trampuz A, Winkler H, Gheysens O, Vanhoenacker F, Petrosillo N, Jutte PC (2019) Consensus document for the diagnosis of prosthetic joint infections: a joint paper by the EANM, EBJIS, and ESR (with ESCMID endorsement). Eur J Nucl Med Mol Imaging 46:971\u2013988","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"5691_CR41","doi-asserted-by":"publisher","first-page":"672","DOI":"10.2106\/00004623-199905000-00008","volume":"81","author":"MJ Spangehl","year":"1999","unstructured":"Spangehl MJ, Masri BA, O\u2019Connell JX, Duncan CP (1999) Prospective analysis of preoperative and intraoperative investigations for the diagnosis of infection at the sites of two hundred and two revision total hip arthroplasties. J Bone Joint Surg Am 81:672\u2013683","journal-title":"J Bone Joint Surg Am"},{"key":"5691_CR42","doi-asserted-by":"publisher","first-page":"245","DOI":"10.33549\/physiolres.930448","volume":"53","author":"I Str\u00edz","year":"2004","unstructured":"Str\u00edz I, Trebichavsk\u00fd I (2004) Calprotectin \u2013 a pleiotropic molecule in acute and chronic inflammation. Physiol Res 53:245\u2013253","journal-title":"Physiol Res"},{"key":"5691_CR43","unstructured":"R Core Team (2021) R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. Available at: https:\/\/www.R-project.org\/"},{"key":"5691_CR44","doi-asserted-by":"publisher","first-page":"9671604","DOI":"10.1155\/2017\/9671604","volume":"2017","author":"TS Teng","year":"2017","unstructured":"Teng TS, Ji AL, Ji XY, Li YZ (2017) Neutrophils and immunity: from bactericidal action to being conquered. J Immunol Res 2017:9671604","journal-title":"J Immunol Res"},{"key":"5691_CR45","doi-asserted-by":"publisher","first-page":"556","DOI":"10.1016\/j.amjmed.2004.06.022","volume":"117","author":"A Trampuz","year":"2004","unstructured":"Trampuz A, Hanssen AD, Osmon DR, Mandrekar J, Steckelberg JM, Patel R (2004) Synovial fluid leukocyte count and differential for the diagnosis of prosthetic knee infection. Am J Med 117:556\u2013562","journal-title":"Am J Med"},{"key":"5691_CR46","doi-asserted-by":"publisher","first-page":"847","DOI":"10.1007\/s00264-021-04958-x","volume":"45","author":"R Trebse","year":"2021","unstructured":"Trebse R, Roskar S (2021) Evaluation and interpretation of prosthetic joint infection diagnostic investigations. Int Orthop 45:847\u2013855","journal-title":"Int Orthop"},{"key":"5691_CR47","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.2106\/JBJS.20.01046","volume":"103","author":"J Warren","year":"2021","unstructured":"Warren J, Anis HK, Bowers K, Pannu T, Villa J, Klika AK, Colon-Franco J, Piuzzi NS, Higuera CA (2021) Diagnostic utility of a novel point-of-care test of calprotectin for periprosthetic joint infection after total knee arthroplasty: a prospective cohort study. J Bone Joint Surg Am 103:1009\u20131015","journal-title":"J Bone Joint Surg Am"},{"issue":"6","key":"5691_CR48","doi-asserted-by":"publisher","first-page":"1153","DOI":"10.1016\/j.arth.2022.01.082","volume":"37","author":"J Warren","year":"2022","unstructured":"Warren J, Klika AK, Bowers K, Colon-Franco J, Piuzzi NS, Higuera CA (2022) Calprotectin lateral flow test: consistent across criteria for ruling out periprosthetic joint infection. J Arthroplasty 37(6):1153\u20131158","journal-title":"J Arthroplasty"},{"key":"5691_CR49","doi-asserted-by":"publisher","first-page":"660","DOI":"10.1302\/0301-620X.99B5.BJJ-2016-0913.R2","volume":"99","author":"M Wouthuyzen-Bakker","year":"2017","unstructured":"Wouthuyzen-Bakker M, Ploegmakers JJW, Kampinga GA, Wagenmakers-Huizenga L, Jutte PC, Muller Kobold AC (2017) Synovial calprotectin: a potential biomarker to exclude a prosthetic joint infection. Bone Joint J-b 99:660\u2013665","journal-title":"Bone Joint J-b"},{"key":"5691_CR50","doi-asserted-by":"publisher","first-page":"1149","DOI":"10.1016\/j.arth.2017.11.006","volume":"33","author":"M Wouthuyzen-Bakker","year":"2018","unstructured":"Wouthuyzen-Bakker M, Ploegmakers JJW, Ottink K, Kampinga GA, Wagenmakers-Huizenga L, Jutte PC, Kobold ACM (2018) Synovial calprotectin: an inexpensive biomarker to exclude a chronic prosthetic joint infection. J Arthroplasty 33:1149\u20131153","journal-title":"J Arthroplasty"},{"key":"5691_CR51","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1186\/s13018-021-02895-4","volume":"17","author":"J Xing","year":"2022","unstructured":"Xing J, Li J, Yan Z, Li Y, Liu X, He L, Xu T, Wang C, Zhao L, Jie K (2022) Diagnostic accuracy of calprotectin in periprosthetic joint infection: a diagnostic meta-analysis. J Orthop Surg Res 17:11","journal-title":"J Orthop Surg Res"},{"key":"5691_CR52","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1302\/2046-3758.98.BJR-2019-0329.R2","volume":"9","author":"Z Zhang","year":"2020","unstructured":"Zhang Z, Cai Y, Bai G, Zhang C, Li W, Yang B, Zhang W (2020) The value of calprotectin in synovial fluid for the diagnosis of chronic prosthetic joint infection. Bone Joint Res 9:450\u2013457","journal-title":"Bone Joint Res"},{"key":"5691_CR53","doi-asserted-by":"publisher","first-page":"1645","DOI":"10.1056\/NEJMra040181","volume":"351","author":"W Zimmerli","year":"2004","unstructured":"Zimmerli W, Trampuz A, Ochsner PE (2004) Prosthetic-joint infections. N Engl J Med 351:1645\u20131654","journal-title":"N Engl J Med"},{"issue":"Suppl 1","key":"5691_CR54","first-page":"S98","volume":"32","author":"B Zmistowski","year":"2014","unstructured":"Zmistowski B, Della Valle C, Bauer TW, Malizos KN, Alavi A, Bedair H, Booth RE, Choong P, Deirmengian C, Ehrlich GD, Gambir A, Huang R, Kissin Y, Kobayashi H, Kobayashi N, Krenn V, Lorenzo D, Marston SB, Meermans G, Perez J, Ploegmakers JJ, Rosenberg A, Simpfendorfer C, Thomas P, Tohtz S, Villafuerte JA, Wahl P, Wagenaar FC, Witzo E (2014) Diagnosis of periprosthetic joint infection. J Orthop Res 32(Suppl 1):S98-107","journal-title":"J Orthop Res"},{"key":"5691_CR55","doi-asserted-by":"publisher","first-page":"1589","DOI":"10.1016\/j.arth.2012.03.059","volume":"27","author":"B Zmistowski","year":"2018","unstructured":"Zmistowski B, Restrepo C, Huang R, Hozack WJ, Parvizi J (2018) Periprosthetic joint infection diagnosis. J Arthroplasty 27:1589\u20131593","journal-title":"J Arthroplasty"}],"container-title":["International Orthopaedics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00264-023-05691-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00264-023-05691-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00264-023-05691-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,26]],"date-time":"2023-03-26T23:06:34Z","timestamp":1679871994000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00264-023-05691-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,19]]},"references-count":55,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,4]]}},"alternative-id":["5691"],"URL":"https:\/\/doi.org\/10.1007\/s00264-023-05691-3","relation":{},"ISSN":["0341-2695","1432-5195"],"issn-type":[{"value":"0341-2695","type":"print"},{"value":"1432-5195","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,19]]},"assertion":[{"value":"3 August 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 January 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 January 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Technical University of Munich Medical School Ethics Committee under No. 26\/19S-SR.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Written informed consent was obtained from the parents.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"This study was performed at the Department of Orthopedics and Sports Orthopedics, Technical University of Munich.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Location of the work"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}